scholarly journals Identifying critical features of type two diabetes prevention interventions: A Delphi study with key stakeholders

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255625
Author(s):  
Jillian C. Ryan ◽  
Bonnie Wiggins ◽  
Sarah Edney ◽  
Grant D. Brinkworth ◽  
Natalie D. Luscombe-March ◽  
...  
Keyword(s):  
Delphi Study ◽  
Digital Health ◽  
Strong Support ◽  
Intervention Development ◽  
Functional Health ◽  
End User ◽  
Prevention Interventions ◽  
Development Processes ◽  
Critical Intervention ◽  
Type Two Diabetes

Aims This study aims to identify critically important features of digital type two diabetes mellitus (T2DM) prevention interventions. Methods A stakeholder mapping exercise was undertaken to identify key end-user and professional stakeholders, followed by a three-round Delphi procedure to generate and evaluate evidence statements related to the critical elements of digital T2DM prevention interventions in terms of product (intervention), price (funding models/financial cost), place (distribution/delivery channels), and promotion (target audiences). Results End-user (n = 38) and professional (n = 38) stakeholders including patients, dietitians, credentialed diabetes educators, nurses, medical doctors, research scientists, and exercise physiologists participated in the Delphi study. Fifty-two critical intervention characteristics were identified. Future interventions should address diet, physical activity, mental health (e.g. stress, diabetes-related distress), and functional health literacy, while advancing behaviour change support. Programs should be delivered digitally or used multiple delivery modes, target a range of population subgroups including children, and be based on collaborative efforts between national and local and government and non-government funded organisations. Conclusions Our findings highlight strong support for digital health to address T2DM in Australia and identify future directions for T2DM prevention interventions. The study also demonstrates the feasibility and value of stakeholder-led intervention development processes.

Development of the Key Performance Indicators for Digital Health Interventions: A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Maria Brenner ◽  
Arielle Weir ◽  
Margaret McCann ◽  
Carmel Doyle ◽  
Mary Hughes ◽  
...  
Keyword(s):  
Scoping Review ◽  
Performance Indicators ◽  
Delphi Study ◽  
Current Knowledge ◽  
Digital Health ◽  
Stakeholder Involvement ◽  
Key Performance Indicators ◽  
Healthcare Services ◽  
Health Interventions ◽  
Original Research

BACKGROUND Development of the Key Performance Indicators for Digital Health Interventions: A Scoping Review OBJECTIVE Digital health interventions (DHIs) offer new methods for delivering healthcare, with the potential to innovate healthcare services. Key performance indicators (KPIs) play a role in evaluation, measurement, and improvement in healthcare quality and service performance. The scoping review question was developed following an initial search to identify literature to assist in the development of KPIs for an ongoing DHI initiative. During the initial search, it became clear that there was limited literature on how to develop specific and measurable KPIs that evaluate DHIs. The aim of this scoping review was to identify current knowledge and evidence surrounding the development of KPIs for DHIs. METHODS A rigorous literature search was conducted across ten key databases: AMED - The Allied and Complementary Medicine Database, CINAHL Complete, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycINFO, EMBASE, EBM Reviews - Cochrane Database of Systematic Reviews, EBM Reviews - Database of Abstracts of Reviews of Effects, EBM Reviews - Health Technology Assessment, and IEEE Xplore. A descriptive summary of the literature was performed, and thematic analysis identified important or reoccurring themes. RESULTS Five references (representing four unique publications) were eligible for the review. Of the four included publications, two were articles on original research studies of a specific DHI, and two were overviews of methods for developing DHIs (not specific to a single DHI). All the included reports discussed the involvement of stakeholders in developing KPIs for DHIs. The step of identifying and defining the KPIs was completed using various methodologies, but all centered on a form of stakeholder involvement. Potential options for stakeholder involvement for KPI identification include the use of an elicitation framework, a factorial survey approach, or a Delphi study. Most of the included articles recognised the lack of literature relating to KPI development for DHIs, compared to the breath of literature available on the development of KPIs in other fields like health or informatics CONCLUSIONS Few articles were identified, highlighting a significant gap in the evidence-based knowledge in this domain. All the included articles discussed the involvement of stakeholders in developing KPIs for DHIs, which was performed using various methodologies. The articles acknowledged a lack of literature related to KPI development for DHIs. To allow comparability between KPI initiatives and facilitate work in the field, further research would be beneficial to develop a common methodology for KPI development for DHIs.

Context in Decision Support Systems Development

2010 ◽  
pp. 93-101 ◽  
Author(s):  
Alexandre Gachet ◽  
Ralph Sprague
Keyword(s):  
Decision Support ◽  
Decision Support Systems ◽  
Support Systems ◽  
Systems Development ◽  
End User ◽  
The Past ◽  
Control Stage ◽  
Development Processes ◽  
Support Methods ◽  
Design And Construction

Finding appropriate decision support systems (DSS) development processes and methodologies is a topic that has kept researchers in the decision support community busy for the past three decades at least. Inspired by Gibson and Nolan’s curve (Gibson & Nolan 1974; Nolan, 1979), it is fair to contend that the field of DSS development is reaching the end of its expansion (or contagion) stage, which is characterized by the proliferation of processes and methodologies in all areas of decision support. Studies on DSS development conducted during the last 15 years (e.g., Arinze, 1991; Saxena, 1992) have identified more than 30 different approaches to the design and construction of decision support methods and systems (Marakas, 2003). Interestingly enough, none of these approaches predominate and the various DSS development processes usually remain very distinct and project-specific. This situation can be interpreted as a sign that the field of DSS development should soon enter in its formalization (or control) stage. Therefore, we propose a unifying perspective of DSS development based on the notion of context. In this article, we argue that the context of the target DSS (whether organizational, technological, or developmental) is not properly considered in the literature on DSS development. Researchers propose processes (e.g., Courbon, Drageof, & Tomasi, 1979; Stabell 1983), methodologies (e.g., Blanning, 1979; Martin, 1982; Saxena, 1991; Sprague & Carlson, 1982), cycles (e.g., Keen & Scott Morton, 1978; Sage, 1991), guidelines (e.g., for end-user computer), and frameworks, but often fail to explicitly describe the context in which the solution can be applied.

scholarly journals Exploring the potential benefits of digital health technology for the management of COPD: a qualitative study of patient perceptions

2019 ◽  
Vol 5 (2) ◽  
pp. 00239-2018 ◽  
Author(s):  
Patrick Slevin ◽  
Threase Kessie ◽  
John Cullen ◽  
Marcus W. Butler ◽  
Seamas C. Donnelly ◽  
...  
Keyword(s):  
Digital Health ◽  
Intervention Development ◽  
Health Technology ◽  
Structured Interview ◽  
Self Management ◽  
Chronic Obstructive ◽  
Preventative Care ◽  
University Hospitals ◽  
Copd Patients ◽  
Potential Benefits

Engaging chronic obstructive pulmonary disease (COPD) patients to actively participate in self-management has proven difficult. Digital health technology (DHT) promises to facilitate a patient-centred care model for the management of COPD by empowering patients to self-manage effectively. However, digital health studies in COPD have yet to demonstrate significant patient outcomes, suggesting that this research has still to adequately address the needs of patients in the intervention development process. The current study explored COPD patients' perceptions of the potential benefits of DHT in the self-management and treatment of their disease.A sample of convenience was chosen and participants (n=30) were recruited from two Dublin university hospitals and each underwent a qualitative semi-structured interview. Thematic analysis of the data was completed using NVivo 12 software.Six themes were identified: symptom management, anxiety management, interaction with physician, care management, personalising care and preventative intervention.In our findings, patients reported a willingness to take a more active role in self-management using DHT. They perceived DHT potentially enhancing their self-management by improving self-efficacy and engagement and by supporting healthcare professionals to practise preventative care provision. The findings can be used to inform patient-centred COPD digital interventions for researchers and clinicians who wish to develop study aims that align with the needs and preferences of patients.

scholarly journals The development of ‘Make One Small Change’: an e-health intervention for the workplace developed using the Person-Based Approach

2019 ◽  
Vol 5 ◽  
pp. 205520761985285
Author(s):  
Ana Howarth ◽  
Jose Quesada ◽  
Todd Donnelly ◽  
Peter R Mills
Keyword(s):  
Digital Health ◽  
Intervention Development ◽  
Health Intervention ◽  
Health Interventions ◽  
Self Monitoring ◽  
User Input ◽  
Online Behaviour ◽  
Guiding Principles ◽  
Small Change ◽  
Evidenced Based

Background The application of digital health interventions is widespread and many employers are implementing employee e-health programs. Intended to enhance productivity by increasing wellbeing, workplace interventions often lack evidence of effectiveness and have low rates of retention. Use of the person-based approach (PBA) is one solution, which offers a systematic framework for developing effective digital health interventions. This paper describes the application of the PBA to the development of ‘Make one small change’ (Cigna MSC™), an online behaviour change system for lifestyle habits focused on resilience, movement, eating and sleep. Method and results The development of Cigna MSC™ took place over four stages with colleagues ( n = 79) across Cigna globally. Application of the PBA entailed using high amounts of qualitative data to inform development and a cyclical process of ‘listening, applying and delivering’ was adhered to throughout. Early stages involved review of current literature and the collection of feedback in relation to existing interventions. Combined, results revealed key intervention development issues that were then used to form guiding principles. Guiding principles ensured intervention objectives translated into relevant design features. The final stages of evaluation included testing images, text and content approaches. Feedback dictated that the intervention should be fun, easy to use and include milestones for self-monitoring. The resulting version was finalised and made ready to pilot so future analysis can be made in relation to real-world engagement and the embedded evaluative content can be used to provide evidence of intervention effectiveness. Conclusions Using the PBA, which was evolved specifically to improve development of digital interventions, resulted in a workplace intervention embedded with in-depth user input combined with evidenced-based theory. This paper illustrates how using a rigorous methodology can drive the creation of an effective digital health intervention that uniquely allows for refinement at each stage.

scholarly journals Challenges for Nontechnical Implementation of Digital Proximity Tracing During the COVID-19 Pandemic: Media Analysis of the SwissCovid App

10.2196/25345 ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e25345
Author(s):  
Viktor von Wyl
Keyword(s):  
Health System ◽  
Resource Competition ◽  
Digital Health ◽  
Intervention Development ◽  
Media Analysis ◽  
Mitigation Measures ◽  
Contact Tracing ◽  
Implementation Challenges ◽  
User Coverage ◽  
Media Reports

Background Several countries have released digital proximity tracing (DPT) apps to complement manual contact tracing for combatting the SARS-CoV-2 pandemic. DPT aims to notify app users about proximity exposures to persons infected with SARS-CoV-2 so that they can self-quarantine. The success of DPT apps depends on user acceptance and the embedding of DPT into the pandemic mitigation strategy. Objective By searching for media articles published during the first 3 months after DPT launch, the implementation of DPT in Switzerland was evaluated to inform similar undertakings in other countries. The second aim of the study was to create a link between reported DPT implementation challenges and normalization process theory for planning and optimizing complex digital health interventions, which can provide useful guidance for decision-making in DPT design and implementation. Methods A Swiss media database was searched for articles on the Swiss DPT app (SwissCovid) published in German or French between July 4 and October 3, 2020. In a structured process, topics were extracted and clustered manually from articles that were deemed pertinent. Extracted topics were mapped to four NPT constructs, which reflected the flow of intervention development from planning, stakeholder onboarding, and execution to critical appraisal. Coherence constructs describe sense-making by stakeholders, cognitive participation constructs reflect participants’ efforts to create engagement with the intervention, collective actions refer to intervention execution and joint stakeholder efforts to make the intervention work, and reflexive monitoring refers to collective risk-benefit appraisals to create improvements. Results Out of 94 articles deemed pertinent and selected for closer inspection, 38 provided unique information on implementation challenges. Five challenge areas were identified: communication challenges, challenges for DPT to interface with other processes, fear of resource competition with established pandemic mitigation measures, unclear DPT effectiveness, and obstacles to greater user coverage and compliance. Specifically, several articles mentioned unclear DPT benefits to affect commitment and to raise fears among different health system actors regarding resource competition. Moreover, media reports indicated process interface challenges such as delays or unclear responsibilities in the notification cascade, as well as misunderstandings and unmet communication needs from health system actors. Finally, reports suggested misaligned incentives, not only for app usage by the public but also for process engagement by other actors in the app notification cascade. NPT provided a well-fitting framework to contextualize the different DPT implementation challenges and to highlight improvement strategies, namely a better alignment of stakeholder incentives, or stakeholder-specific communication to address their concerns about DPT. Conclusions Early experiences from one of the first adopters of DPT indicate that nontechnical implementation challenges may affect the effectiveness of DPT. The NPT analysis provides a novel perspective on DPT implementation and stresses the need for stakeholder inclusion in development and operationalization.

scholarly journals Regulatory Sandboxes: A Cure for mHealth Pilotitis? (Preprint)

2020 ◽  
Author(s):  
Abhishek Bhatia ◽  
Rahul Matthan ◽  
Tarun Khanna ◽  
Satchit Balsari
Keyword(s):  
Digital Health ◽  
Contact Tracing ◽  
User Needs ◽  
End User ◽  
Health Seeking ◽  
Testing Environment ◽  
The Past ◽  
Seeking Behavior ◽  
The Law ◽  
Epidemic Prediction

UNSTRUCTURED Mobile health (mHealth) and related digital health interventions in the past decade have not always scaled globally as anticipated earlier despite large investments by governments and philanthropic foundations. The implementation of digital health tools has suffered from 2 limitations: (1) the interventions commonly ignore the “law of amplification” that states that technology is most likely to succeed when it seeks to augment and not alter human behavior; and (2) end-user needs and clinical gaps are often poorly understood while designing solutions, contributing to a substantial decrease in usage, referred to as the “law of attrition” in eHealth. The COVID-19 pandemic has addressed the first of the 2 problems—technology solutions, such as telemedicine, that were struggling to find traction are now closely aligned with health-seeking behavior. The second problem (poorly designed solutions) persists, as demonstrated by a plethora of poorly designed epidemic prediction tools and digital contact-tracing apps, which were deployed at scale, around the world, with little validation. The pandemic has accelerated the Indian state’s desire to build the nation’s digital health ecosystem. We call for the inclusion of regulatory sandboxes, as successfully done in the fintech sector, to provide a real-world testing environment for mHealth solutions before deploying them at scale.

scholarly journals Regulatory Sandboxes: A Cure for mHealth Pilotitis?

10.2196/21276 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e21276
Author(s):  
Abhishek Bhatia ◽  
Rahul Matthan ◽  
Tarun Khanna ◽  
Satchit Balsari
Keyword(s):  
Digital Health ◽  
Contact Tracing ◽  
User Needs ◽  
End User ◽  
Health Seeking ◽  
Testing Environment ◽  
The Past ◽  
Seeking Behavior ◽  
The Law ◽  
Epidemic Prediction

Mobile health (mHealth) and related digital health interventions in the past decade have not always scaled globally as anticipated earlier despite large investments by governments and philanthropic foundations. The implementation of digital health tools has suffered from 2 limitations: (1) the interventions commonly ignore the “law of amplification” that states that technology is most likely to succeed when it seeks to augment and not alter human behavior; and (2) end-user needs and clinical gaps are often poorly understood while designing solutions, contributing to a substantial decrease in usage, referred to as the “law of attrition” in eHealth. The COVID-19 pandemic has addressed the first of the 2 problems—technology solutions, such as telemedicine, that were struggling to find traction are now closely aligned with health-seeking behavior. The second problem (poorly designed solutions) persists, as demonstrated by a plethora of poorly designed epidemic prediction tools and digital contact-tracing apps, which were deployed at scale, around the world, with little validation. The pandemic has accelerated the Indian state’s desire to build the nation’s digital health ecosystem. We call for the inclusion of regulatory sandboxes, as successfully done in the fintech sector, to provide a real-world testing environment for mHealth solutions before deploying them at scale.

Development of an adolescent alcohol misuse intervention based on the Prototype Willingness Model

2016 ◽  
Vol 116 (3) ◽  
pp. 275-291 ◽  
Author(s):  
Emma Davies ◽  
Jilly Martin ◽  
David Foxcroft
Keyword(s):  
Delphi Method ◽  
Delphi Study ◽  
Alcohol Misuse ◽  
Intervention Development ◽  
Risk Behaviour ◽  
Social Pressure ◽  
Behaviour Change Techniques ◽  
Content Type ◽  
Prototype Willingness Model ◽  
Adolescent Alcohol

Purpose – The purpose of this paper is to report on the use of the Delphi method to gain expert feedback on the identification of behaviour change techniques (BCTs) and development of a novel intervention to reduce adolescent alcohol misuse, based on the Prototype Willingness Model (PWM) of health risk behaviour. Design/methodology/approach – Four BCTs based on the PWM were identified and incorporated into a draft intervention that aimed to change alcohol prototypes and enable adolescents to deal with social pressure. Using the Delphi process, successive questionnaires were distributed to 20 international experts to build consensus on the theoretical validity of the intervention. Findings – In total, 15 experts completed round 1 and 11 completed round 2 of the Delphi study. A high level of consensus was achieved. Four priority areas were identified to improve the intervention: incorporating extra techniques to address social pressure; increasing intensity; providing incentives; and addressing credibility. Research limitations/implications – The sample of experts was self-selected and four participants were lost between the first and second round of the study. Practical implications – The effectiveness of the identified BCTs will be evaluated within an intervention to reduce alcohol misuse in adolescents. Further work should build towards a more unified approach to developing interventions based on the PWM. The Delphi method is likely to be particularly useful when there is no existing consensus about which BCTs to use that reflect certain theoretical constructs or that best target a specific population or behaviour. Originality/value – This paper is the first to address the identification of specific BCTs based on the PWM and thus makes an important contribution to the application of this model to interventions. This novel application of the Delphi method also makes a useful addition to the growing field of intervention development and design.

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